筋膜手法联合协调中心点冲击波治疗腰椎间盘突出症的疗效观察  

The clinical efficacy of fascia manipulation combined with coordinated center point extracorporeal shock wave shock therapy for lumbar disc herniation

作　　者：陈浩男 张先鹏 涂展 孔之寅 杜文喜[1] Chen Haonan

机构地区：[1]浙江中医药大学附属第一医院(浙江省中医院),310006

出　　处：《浙江临床医学》2025年第1期40-42,共3页Zhejiang Clinical Medical Journal

摘　　要：目的观察筋膜手法(FM)联合协调中心点(CC)体外冲击波(ESWT)治疗腰椎间盘突出症(LDH)的疗效。方法选取LDH患者60例,随机分为A、B两组,每组各30例,A组行常规FM治疗,B组行常规FM联合CC点ESWT治疗,每个疗程3 d,总疗程1个月。采用CC点压痛阈值(PPT)、视觉模拟评分(VAS)、日本骨科协会评分(JOA)、改良Macnab疗效评价标准进行评估。结果治疗1个月后两组PPT值、VAS及JOA均较治疗前明显改善,差异有统计学意义(P<0.05),两组15 d的PPT值提升均高于1个月(P<0.05),B组治疗1个月后6个后向肌筋膜单元(MFU)CC点:后-腰(re-lu)、后-骨盆(re-pv)、后-髋(re-cx)、后-膝(re-ge)、后-踝(re-ta)、后-足(re-pe)的PPT值均高于A组(P<0.05)。治疗后B组JOA高于A组,VAS低于A组,差异有统计学意义(P<0.05)。治疗结束后1个月B组总有效率93.3%,A组总有效率83.3%,差异无统计学意义(P>0.05)。结论FM联合CC点ESWT可以改善LDH患者的腰腿部疼痛及活动功能,临床疗效显著。Objective To observe the clinical efficacy of fascia manipulation(FM)combined with coordinated center point(CC)extracorporeal shock wave(ESWT)shock therapy for lumbar disc herniation(LDH).Methods Sixty LDH beneficiaries admitted to the Orthopedics Outpatient Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine were randomly divided into two groups,A and B,with 30 cases in each group.The group A received conventional FM treatment,while the group B received conventional FM combined with CC point ESWT treatment.The treatment course was 3 days/time,with 10 consecutive treatments,for a total treatment course of 1 month.The clinical outcomes were evaluated using CC point tenderness threshold(PPT),visual analog scale(VAS),Japanese Orthopedic Association score(JOA),and modified Macnab efficacy evaluation criteria.Results After one month of treatment,the PPT values,VAS,and JOA of the two groups improved significantly compared to before treatment,and there was a statistically significant difference(P<0.05).Comparing the PPT values of the two groups,the PPT improvement in the first half of the two groups was higher than that in the second half.After one month of treatment,the PPT values of the CC points of the posterior myofascial unit(MFU)in the group B were higher than those in the group A,including the posterior lumbar(re-lu),posterior pelvic(re-px),posterior competitive(re-cx),posterior knee(re-ge),posterior ankle(re-ta),and posterior foot(re-pe)(P<0.05).After treatment,JOA in the group B was significantly higher than that in the group A,while VAS was lower than that in the group A,and the comparison also showed statistical differences(P<0.05).The total effective rate of the group B was 93.3%,which was higher than the group A's 83.3%,but there was no statistical difference in the effective rate between the two groups(P>0.05).Conclusion FM combined with CC point ESWT can improve lower back and leg pain and activity function in LDH patients,with significant clinical efficacy.

关 键 词：腰椎间盘突出症 筋膜手法 体外冲击波 

分 类 号：R68[医药卫生—骨科学]